Name of court in sending state requesting judicial assistance
Name of plaintiff Docket number V. Name of defendant
Request for international judicial assistance (letter rogatory) (name of the requesting court) presents its compliments to the appropriate judicial authority of (name of receiving state), and requests international judicial assistance to (obtain evidence/effect service of process) to be used in a (civil, criminal, administrative) proceeding before this court in the above captioned matter. A (trial/hearing) on this matter is scheduled at present for (date) in (city, state, country). This court requests the assistance described herein as necessary in the interests of justice. The assistance requested is that the appropriate judicial authority of (name of receiving state) (compel the appear of the below named individuals to give evidence/produce documents) (effect service of process upon the below named individuals). (names of witnesses/persons to be served) (nationality of witnesses/persons to be served) (addressed of witnesses/persons to be served) (description of documents or other evidence to be produced) Facts